Syzdykova Madina, Morenko Marina, Shnaider Kseniya, Urazova Saltanat, Saltabayeva Ulbossyn, Bugayeva Nelli, Kagenova Zhuldyzay
Department of Children's Diseases with courses in Allergology, Immunology, Hematology and Endocrinology, NJSC "Astana Medical University", Astana, Kazakhstan.
Department of Family Medicine, NJSC "Astana Medical University", Astana, Kazakhstan.
PLoS One. 2025 Apr 22;20(4):e0322204. doi: 10.1371/journal.pone.0322204. eCollection 2025.
Bronchopulmonary dysplasia (BPD) presents a significant respiratory challenge in infants born prematurely. Socioeconomic factors and environmental determinants, including altitude, play pivotal roles in shaping respiratory health outcomes among premature infants. This study aimed to investigate the prevalence of BPD among preterm infants based on altitude, considering the impact of altitude correction on prevalence estimates. By examining altitude-related variations in BPD prevalence, the study sought to provide insights essential for guiding interventions aimed at preventing and managing respiratory conditions in this vulnerable population. The study protocol was registered with PROSPERO, and a systematic search of five databases (PubMed, Web of Science, ScienceDirect, ProQuest, and Google Scholar) was conducted without any restrictions on the date of publication. Eligible studies were identified based on predefined inclusion criteria, including retrospective or prospective studies reporting BPD prevalence at different altitudes, the use of standard diagnostic criteria for BPD, and the exclusion of studies involving non-human subjects or those lacking altitude-adjusted data. The risk of bias assessment was conducted using the Critical Appraisal Skills Programme checklist. Statistical analysis included calculating pooled prevalence estimates using a random-effects model, performing subgroup analyses, and assessing heterogeneity and publication bias. The search yielded 339 records, of which ten articles met the inclusion criteria and had a low risk of bias. The altitude-unadjusted BPD prevalence was 41.35% (95% CI 28.62; 55.34%) and ranged from 19.73% (95% CI 16.44; 23.48%) to 71.02% (95% CI 68.33; 73.56%) across different altitude categories. The altitude-adjusted pooled mean BPD prevalence was 26.70% (95% CI 19.60; 35.25%). This systematic review and meta-analysis highlight altitude-related variations in BPD prevalence among preterm infants. Altitude adjustment is crucial for understanding the true prevalence of BPD and guiding tailored interventions in high-altitude regions.
支气管肺发育不良（BPD）给早产婴儿带来了重大的呼吸挑战。社会经济因素和环境决定因素，包括海拔高度，在塑造早产婴儿的呼吸健康结果方面起着关键作用。本研究旨在基于海拔高度调查早产婴儿中BPD的患病率，同时考虑海拔校正对患病率估计的影响。通过检查BPD患病率与海拔相关的变化，该研究旨在提供重要见解，以指导针对这一脆弱人群预防和管理呼吸道疾病的干预措施。该研究方案已在PROSPERO注册，并对五个数据库（PubMed、科学网、ScienceDirect、ProQuest和谷歌学术）进行了系统检索，对发表日期没有任何限制。根据预先定义的纳入标准确定符合条件的研究，包括报告不同海拔高度BPD患病率的回顾性或前瞻性研究、使用BPD的标准诊断标准，以及排除涉及非人类受试者或缺乏海拔调整数据的研究。使用批判性评估技能计划清单进行偏倚风险评估。统计分析包括使用随机效应模型计算合并患病率估计值、进行亚组分析以及评估异质性和发表偏倚。检索结果共339条记录，其中十篇文章符合纳入标准且偏倚风险较低。未进行海拔校正时，BPD患病率为41.35%（95%置信区间28.62；55.34%），在不同海拔类别中从19.73%（95%置信区间16.44；23.48%）到71.02%（95%置信区间68.33；73.56%）不等。经海拔校正后的合并平均BPD患病率为26.70%（95%置信区间19.60；35.25%）。这项系统评价和荟萃分析突出了早产婴儿中BPD患病率与海拔相关的变化。海拔校正对于了解BPD的真实患病率以及指导高海拔地区的针对性干预措施至关重要。
